CAJ | 학술논문

目的：探讨多层螺旋CT血管成像（MSCTA）及图像后处理技术对自发孤立性肠系膜上动脉夹层（SIDSMA）的诊断价值。方法回顾性分析21例SIDSMA患者MSCTA及后处理图像资料，观察评估夹层破裂口、真假腔、剥离内膜片、夹层范围、分支受累情况、肠管有无缺血等影像征象。结果21例患者明确显示破口者14例，破口距离肠系膜上动脉（SMA）起始部1.4~5.5 cm；夹层范围5.5~15.9 cm；清晰显示剥离内膜片14例；假腔血栓者18例；显示假性动脉瘤6例；动脉瘤样扩张3例，夹层动脉瘤破裂1例；真腔狭窄17例；真腔主干闭塞2例；SMA分支受累12例；2例患者局部肠道缺血性改变。结论MSCTA及图像后处理技术能对SIDSMA明确诊断及准确评估，有利于临床治疗方案的选择。
목적：탐토다층라선CT혈관성상（MSCTA）급도상후처리기술대자발고립성장계막상동맥협층（SIDSMA）적진단개치。방법회고성분석21례SIDSMA환자MSCTA급후처리도상자료，관찰평고협층파렬구、진가강、박리내막편、협층범위、분지수루정황、장관유무결혈등영상정상。결과21례환자명학현시파구자14례，파구거리장계막상동맥（SMA）기시부1.4~5.5 cm；협층범위5.5~15.9 cm；청석현시박리내막편14례；가강혈전자18례；현시가성동맥류6례；동맥류양확장3례，협층동맥류파렬1례；진강협착17례；진강주간폐새2례；SMA분지수루12례；2례환자국부장도결혈성개변。결론MSCTA급도상후처리기술능대SIDSMA명학진단급준학평고，유리우림상치료방안적선택。
ObjectiveToevaluatethevalueofmulti-slicespiralCTangiography(MSCTA)withpost-processing image features in the diagnosis of spontaneous isolated dissection of superior mesenteric artery(SIDSMA).MethodsMSCTAandpost-processingimagesof 21SIDSMApatientswerereviewed retrospectively. Multiple post-processing techniques were used to analyze the image data such as dissection rupture, true and false lumen, intimalfiaps, extent of interbed, branches’affected situation andpresenceofischemia.ResuItsInthese 21patients,therewere 14patientshadclearruptures.Thedistance fromtheoriginofthesuperiormesentericartery (SMA)tothetearrangedfrom 1.4cmto 5.5cm.Thelengthof dissectionrangedfrom 5.5cmto 15.9cm.Therewere 14patientshadclearintimalfiaps, 18patientshadfalse lumenthrombosis, 6patientshadpseudoaneurysmofSMA, 3patientshadaneurysmaldilatationofthe SMA. 1patienthaddissectinganeurysmruptured. 17patientshadstenosisofthetruelumen, 2patients hadSMAtrunkocclusion, 12patientshadSMAbranchesinvolvement,and 2patientshadacutesmall intestinalischemia. ConcIusionMSCTAandimagepost-processingtechniqueprovidecleardiagnosis and accurate evaluation of SIDSMA, which are helpful for the choice of clinical therapy.